Our research into type 1 diabetes at the Royal Free Hospital

20 December 2017

Dr Miranda Rosenthal works in the Royal Free Hospital’s diabetes clinic, where part of her role is to give the local population the opportunity to take part in research that helps them understand why people develop type 1 diabetes. We asked her some questions about her work and how it links in with the research work carried out by the Institute of Immunity and Transplantation at the Royal Free Hospital.

Visitors to the clinic are mainly from the Camden and Barnet areas, and around 230 people so far have happily agreed to help the IIT’s research.

Among other things, the clinic offers a specialist insulin pump service for adults with type 1 diabetes. This type of therapy is particularly helpful for those who have severe recurrent hypoglycaemic unawareness as a result of insulin therapy. An insulin pump is a pager-size electronic device that provides the wearer with a tailor-made slow release of insulin, so they do not need multiple daily injections.

The aim of the therapy is to offer improved control without ‘hypos’ (hypoglycemia), aiming to mimic better a normal pancreas’s insulin production. This means users suffer fewer negative effects and are able to get on with their lives more easily. Dr Miranda Rosenthal said

"We are able to treat many of our patients with these pumps, so about 30% of people in the local area with this type of diabetes use them, compared with just 1–2% of the general UK population."

The clinic also offers a pancreatic islet transplantation service. This is when healthy parts of a pancreas are taken from a deceased donor and put into a person with type 1 diabetes, enabling the recipient’s body to produce some of its own insulin. It is only a very small service at present, as it is quite an invasive treatment, but it is another way for people to deal with their severe recurrent hypoglycaemic unawareness and improve the way they live their lives. It is certainly an ideal model for the possible direction of stem cell research in the future.

When we asked Dr Miranda Roasenthal how her work helps researchers, she said she recruits people with type 1 diabetes to help the research done in the IIT – the first time that this kind of opportunity has been available to residents in North London.

People who sign up provide up to five blood samples over three years. These samples are a vital part of the research, enabling researchers to look at the stability of biomarkers over time and investigate the immunological characteristics that are shared.

The ultimate goal is to be able to develop and offer new trials and treatments. Dr Miranda Rosenthal said their current research is the start of a journey that they hope will make future treatments for type 1 diabetes available faster for people living locally.

The IIT in the Pears Building will be perfectly placed to do this, as it will bring scientists, doctors and patients together in one site – the only immunology research centre outside the USA to do so.